Seeling W, Mayer T, Wörsdorfer O
Reg Anaesth. 1985 Jan;8(1):1-4.
21 patients with stiffness of the knee were operated on, for mobilisation under epidural analgesia. As soon as the patients returned to the ward the leg was placed on a mobilisation-splint driven by an electric motor. Epidural analgesia was continued by infusion of 0.25 ml/kg . h of 0.125% bupivacaine via epidural catheter for a period of four to six days whereafter the catheter was removed. Analgesia during mobilisation was complete or almost complete in 15 patients. In 5 cases loss of sensitivity was present predominantly or selectively in the contralateral extremity, in one patient segmental extension of epidural analgesia did not include the knee. The bladder had to be catheterized in 9 patients, three suffered from decubital ulcers which disappeared after removal of the epidural catheter. In spite of the frequency of side effects, which can be diminished by further experience, continuous epidural analgesia is advantageous for early mobilisation of the knee after arthrolysis. The patients must be informed about side effects and possible complications before giving their consent for this method of long lasting analgesia.
21例膝关节僵硬患者接受手术，在硬膜外镇痛下进行关节活动。患者一回到病房，腿部就被放置在由电动马达驱动的活动夹板上。通过硬膜外导管以0.25 ml/kg·h的速度输注0.125%布比卡因持续4至6天，之后拔除导管，继续进行硬膜外镇痛。15例患者在活动期间镇痛完全或几乎完全。5例患者对侧肢体主要或选择性地出现感觉丧失，1例患者硬膜外镇痛的节段性延伸未包括膝关节。9例患者需要导尿，3例患有褥疮，在拔除硬膜外导管后褥疮消失。尽管副作用发生率较高（随着经验增加可能会减少），但持续硬膜外镇痛有利于关节松解术后膝关节的早期活动。在患者同意采用这种长效镇痛方法之前，必须告知他们副作用和可能的并发症。
